stress

All posts tagged stress

The Respiratory Team paid one of their routine visits to mum at the beginning of the week and were concerned enough to feed straight back to the Community Matron. Sarah put in an appearance later in the day, listened to mum’s chest and diagnosed the beginnings of pneumonia. Luckily we had antibiotics and steroids in the flat just in case of such an eventuality, but one of the inhalers had run out over the weekend, so Sarah set off to the GP’s surgery to make sure that the relevant prescriptions were issued and that mum’s doctor knew she was unwell.

Having smugly congratulated myself on producing the standby medication so promptly I was surprised and worried to find the box of Amoxicillin was empty… I made a further frantic phone call to the GP, sharing Sarah’s earlier frustration at having to go through various menus, to ensure that a script was sent direct to the pharmacist and then despatched to mum before the end of the day. Trust me to choose that day to visit without my car.

Whilst I was worrying about the missing antibiotics I decided it was time to move the furniture in the bedroom. We had been advised that the bed (with its rubber mattress) should not be alongside the radiator, so Emma, the carer, and I emulated Pickfords removal men whilst we dragged chairs and chests of drawers out of the room in order to swing the bed around. Initially we placed it facing the wrong way, where the telly would not be visible, so we had to disturb mum again, much to her annoyance. After plugging the mattress and the control pad back into the wall we found that the pad was doing nothing at all and the mattress was flat. Cue more complaints and moans from the patient. The light was on but it was completely unresponsive at 5.10 in the afternoon when Medequip had gone home for the day. The emergency number that was supposed to be on the equipment was not there and googling for it was impossible given that the flat is in a mobile phone black spot. Although I had no car I at least had my mobile WiFi so was able to get online, find a number and make the necessary call. It was all so simple once I was told how to rectify the problem, but why on earth weren’t those instructions delivered with the bed?

The next day was spent trying not to worry about mum and hoping that she would respond to her medication as the alternative was hospitalisation and we were fully aware that she would not want to go there. I know now that she is doing better, so that’s another mini crisis averted.

Sarah was also concerned that mum has generally deteriorated over the 10 days since she last saw her and that her COPD has worsened so she delivered an End of Life Pack, containing the necessary injectable medication for making mum comfortable when the time comes. She also informed me that she is making an application to the local council for continuing funding. Whether we get it will be another matter, but we are keeping everything crossed. We have been using mum’s personal savings to fund her care and the money is disappearing rapidly; it would be a relief not to have to fret about finances too.

So for now we can wave goodbye to the Old Man’s Friend and hope that the funding is approved and that mum remains stable.

Once mum had been bedridden for more than a week we began to get seriously concerned and made contact with the GP, who acted swiftly and put one of the Community Matrons in touch with me. Two days later she visited mum to assess her needs. We also decided that it was time for mum to have round the clock care and organised a roster of known and trusted people to stay with her overnight, whilst seeking out a new care agency that would be able to provide continuous daytime cover.

This was all in place when Sarah visited to carry out her assessment. She swiftly took charge, insisted mum mobilise to the bathroom and gave a few pointers to the carers. Mum will now be prompted to take in more fluids, as she is obviously dehydrated, and will be encouraged to try to eat a little more. Food will be given to her, rather than her deciding that she only wants bread and butter. She will also be encouraged to get out of bed, with lots of help. I was amazed when I watched Sarah escort her (plus Zimmer frame) along the hall as I was convinced that she was far too weak to manage. The difference between a health care professional is that they can employ the firmness that a daughter, who has been brought up to be obedient, cannot. Just like Mary Poppins, Sarah is firm … but kind.

Sarah demonstrated her skills and training when she told me that she would be in touch with the GP to ask for a home visit, would contact social services on our behalf, would arrange for bloods to be taken and would also contact the domiciliary podiatry service to arrange a visit. She has also ordered a hospital bed to be delivered next week, so I need to arrange for collection of mum’s double bed. Sarah is a far cry from Hattie Jacques’s matron in the Carry On films, but every bit as capable, knowledgeable and caring.

To complement her input there is also the new care agency. They carried out a thorough evaluation of mum’s medical needs and medication, a risk assessment of her home, wrote out a detailed daily care plan (which was also augmented with Sarah’s suggestions) and asked me about mum’s interests and the work she had done before she retired.

I’m feeling far more optimistic and reassured. Some of the weight and anxiety have been lifted off my shoulders thanks to Sarah and the girls from Insta Care

It’s been a long journey since mum broke her hip nearly eighteen months ago, and was then diagnosed with Vascular Dementia earlier this year. At one time I used to visit once a week and we would generally go for a pub lunch or afternoon tea, now I visit twice a week and have trouble finding things to talk about. As time goes on she has less and less interest in the outside world, friends and family and no longer follows her beloved soaps on the telly. Her frailty and disability mean that leaving the flat involves a great deal of effort. An able bodied person would feel tired contemplating the difficulty of getting her ouside and into the car.

Initially Careline, with its accompanying red buttoned bracelet was a safety back up; now it is pressed with increasing regularity and ambulances arrive and paramedics pick mum up from the floor when she has fallen and persuade her to go to hospital when they think it necessary. There are the other occasions when she summons help but can’t hear the responder at the other end, so of course they send in the emergency services as a precaution – what mum refers to as the army and the navy arriving. We’ve given up dashing over when Careline phone telling us that mum has been buzzing: we are aware of our physical and mental weaknesses and the need to try to conserve our strength. As she still refuses to move to residential care, we remain on alert, anxious and worried what each day will bring.

When we were visiting every day after mum’s discharge from hospital with a repaired hip, we soon realised that we couldn’t carry on indefinitely. The almost daily hospital visits, plus more than three weeks of going to her home every day (in my case remaining until she was safely in bed at night) began to take their toll. So we scaled back, in my case to twice a week as I have already mentioned.

I could feel myself becoming tired, ratty, irritable and tearful, but believed I needed to do my best for my mother. Whenever I felt exhausted it somehow never seemed like exhaustion when I moved on to the next level of even greater fatigue. For some months I (who rarely have trouble sleeping) have been suffering from various degrees of insomnia.

I gleefully pounced on the opportunity of taking a course of stress management workshops provided by my local Carers organisation. Believe me it is easy to do the theory, but trying to practise positive thinking, flip the negativity and fit in relaxing meditations is not as easy as you want it to be. We all bonded well and it was therapeutic to discuss our caring roles and their challenges with others in a similar position.

I also attended dementia awareness workshops, which will lead to another regular support group. In addition I have been seeing a counsellor for about a year and trying to work through problems that go back to my childhood and are now compounded with everything else happening in my life.

The final straw was when I needed to visit my GP at the weekend and the waterworks welled up again. She insisted on anti-depressants and I didn’t argue. If they take the edge off the anxiety and the stress I don’t care. This hamster is unable to climb out of her wheel at present, so she keeps whirring round and round and swallows her pills like the good little girl mummy taught her to be.

It’s been a difficult time. When visiting mum a few weeks ago she was having trouble getting out of her chair; I put this down to a mobility problem and helped her up. The following day I had a phone call from Careline (the company that responds to her calls for help when she presses the button on her bracelet) telling me that she was again unable to get out of her chair. Knowing her afternoon carer would be there before me I let it go and hoped for the best. A little later my sister phoned to say that mum had pressed several times (in fact about 12 in total) and that I should go over. When I arrived she was in bed and four attempts at standing up proved futile, so I phoned for an ambulance. She was duly taken to A&E, diagnosed with a UTI and sent home with antibiotics.72 hours later I had a phone call from a paramedic who was with mum, as she had again pressed for help numerous times. She was persuaded to go into hospital, diagnosed with a chest infection, and remained there for three days.

From our point of view, which was endorsed by her carers and other health care professionals, she really needed to be in a care home. My sister tried to persuade her of the benefits of one we had found not far from where she lives, and that would also allow her to take her cat, her ‘baby’. Still she dug in her heels and insisted she wanted to go home, so back home we went.I organised another assessment with her social worker for the following Monday and in spite of everything he pronounced that she still had capacity and could not be forced to go anywhere she didn’t want to go to. So the two of us continued to operate on high alert with our anxiety and stress levels building, wondering when the next fall or hospital admission would occur.

We didn’t have long to wait before the buzzer was pressed more and more frequently and she was again admitted and kept in for two nights. Her discharge home was not an easy one. She was delivered by patient transport, which was actually a man driving a minibus, and not a paramedic or somebody with any kind of medical training. She beckoned to me with a face like thunder and screamed that she had been waiting since 9 o’clock that morning – it was now about 2pm. I had to help her down to her waiting Zimmer frame, but she was not strong enough to use it to walk into the block and her own flat, so I had to dash back in again for her wheelchair. When I asked the driver if he could just make sure that she was steady until I got back, I was informed by one of the other passengers that he was ‘only the driver’.

By 4am the following day she was again calling for help; an ambulance was duly summoned but she remained at home. Since then she has been more tired and lethargic and when I visited earlier this week she didn’t even have the energy to get out of bed.On the advice of the Alzheimers Society we have bumped up her care so that somebody is with her throughout the night, and we are trying to arrange for care during the rest of the day. At least the presence of another person will stop the panicky demands on Careline, who are often unable to elicit a response because of her poor hearing, so feel they must send another ambulance. One major problem is that the response time can be up to four hours.

We are still working on the idea of residential care, but not sure how on earth we will manage it, especially if she is too weak to get out of bed and walk to the car. In addition the home will initially only assess her during the day and overnight.It is apparent to everybody but her that she needs to be looked after in a caring environment where there are skilled people, friendly faces and nutritious meals. Where there will be somebody to reassure her when she gets worried and confused and above all where she will be in a place of safety. We haven’t given up hope yet, but we have to contend with her independent stubborn streak that makes her too obstinate for her own good.

Somebody once told me that you’re never truly grown up while your parents are still alive. Well my dad died more than 30 years ago, but you’ve probably seen from some of my other posts that my mum is still with us, even if not in the best of health.

When we were children I can recall my grandma worrying about us, and my mum’s response used to be that she couldn’t wrap us in cotton wool. My sister and I grew up and made our own lives and mum continued to live hers in her own way. Sometimes it seems that she’s invincible: a heart attack, a close call with pneumonia, a broken hip and now dementia. A few years ago when she was healthier she used to give me pep talks and remind me that she wouldn’t be around forever but her GP has referred to the indomitable spirit that has kept her going.

However (I bet you heard that word coming) she is becoming weaker and frailer. Her lack of interest in food means that her calorie consumption has dropped with the resultant loss of weight. She probably has no idea what she looks like as she won’t permit herself to use a mirror. The lady that was known for clacking around on her high heels now slops around with back-trodden slippers, using a Zimmer frame for balance. Her pride in her appearance has gone as she has no interest in checking it. Her former insistence on foundation garments (a good bra and a belt) has been transplanted by going bra-less and wearing knickers that are several sizes too large, and sometimes the latter fall off so she goes commando at home. Make up is now never applied, with the exception of a bit of lippy for a funeral a few weeks ago, she hasn’t had her hair done for more than six months and many of her clothes have burn holes from the careless discarding of cigarettes.

This morning my sister phoned to tell me that even mum’s carer was concerned at her lack of energy and interest. All she wants to do is stay in bed and sleep, or go back to bed for another sleep if she has been persuaded to leave her bed. The mother who would never get dressed without having a bath, now has to be coerced into getting in the tub about once a week, and often shows a lack of interest in even having a wash.

I’m sure many others have been in my position and it will continue to happen. But how do you stand by whilst a loved parent neglects themselves to such an extent? She isn’t tempted by food, stating that she’s never enjoyed it anyway. The less she eats the more her stomach shrinks and the less she can cope with. A while ago I scrambled two eggs and put them on two small slices of toast: one for her and one for me. Even her portion was more than she could eat. She used to love my scrambled eggs, and my husband is often critical of ones that are served in restaurants or hotels, preferring my lighter, fluffier home-made versions.

Unfortunately I missed the doctor’s responses to my phone call, so will have to speak to them tomorrow although I don’t know what they can suggest or do. She refuses to drink the Complan that has been prescribed to add to the few calories she consumes, and all the health care professionals state that she maintains capability so her wishes have to be respected.

Tomorrow I will visit again, armed with another 200 cigarettes as she values them more than she does food. I will again phone the doctor and see if somebody can visit her at home while I am there, so that I can countermand her declarations that she is fine. If she isn’t too tired I may be able to encourage her to watch some Wimbledon tennis on the television, or I will deal the cards for a few more hands of kalooki, and I will again try to coax her into eating something, in spite of her protestations that she doesn’t really fancy anything.

And all the while I will try to put into practice what my counsellor is trying to instil in me: the fact that I am important and do matter and must take care of myself, and I will also attempt to work on the de-stressing strategies and spare some time for relaxation meditation before my next workshop to counteract the stress of keeping all the balls in the air at the same time.

One rather tired hamster wants to climb out of her wheel until tomorrow and build up the reserves needed to cope with another day. If only I could get a good night’s sleep. The irony is not lost on me: my mother just wants to sleep, and I can’t.